食管黏膜病变内镜黏膜下剥离术前和术后的临床病理分析

发布时间：2018-06-27 04:24

本文选题：早期食管癌 + 上皮内瘤变　；参考：《中国内镜杂志》2017年10期

【摘要】：目的回顾性分析早期食管癌和癌前病变的内镜下特征及临床病理特征,探讨内镜黏膜下剥离术(ESD)治疗的必要性、安全性和有效性。方法纳入2013年5月-2016年4月经白光内镜及病理活检诊断为早期食管癌及上皮内瘤变的患者51例,分析毛细血管袢(IPCL)、碘染色、术前术后病理结果及相关并发症的发生情况。结果 51例患者共58处病变,IPCL分类58处病变中A型8处(13.79%),B1型44处(75.86%),B2型6处(10.34%);术前活检结果 11处(18.97%)为低级别上皮内瘤变(LGIN),42处(72.41%)为高级别上皮内瘤变(HGIN),5处(8.62%)为鳞状细胞癌,术后病理结果 10处(17.54%)病变为LGIN,27处(46.55%)为HGIN,21处(36.21%)病变为鳞状细胞癌,术前术后病理结果符合率为60.34%。微穿孔、狭窄和术后迟发性出血的概率分别为0.00%(0/58)、8.62%(5/58)和3.45%(2/58)。结论 ESD术后食管早癌的检出率显著增加,术前活检对诊断和治疗有指导意义,ESD治疗能减少食管早癌的漏诊。
[Abstract]:Objective to review the endoscopic features and clinicopathological features of early esophageal and precancerous lesions, and to explore the necessity, safety and effectiveness of endoscopic submucosal dissection (ESD). Methods 51 cases of early esophageal and intraepithelial neoplasia were diagnosed as early esophageal and intraepithelial neoplasia in 4 menstrual period -2016 in May 2013, and the analysis of hair was analyzed. Microvascular loop (IPCL), iodine staining, preoperative and postoperative pathological results and related complications occurred. Results 51 patients were 58 lesions, 8 of A type 8 (13.79%), 44 B1 type (75.86%) and 6 B2 (10.34%) in 58 lesions. Preoperative biopsy results were low grade intraepithelial neoplasia (LGIN), 42 (72.41%) were high grade of intraepithelial neoplasia. Tumor change (HGIN), 5 (8.62%) squamous cell carcinoma, 10 (17.54%) pathological changes were LGIN, 27 (46.55%) was HGIN, 21 (36.21%) was squamous cell carcinoma. The coincidence rate of preoperative and postoperative pathological results was 60.34%. micro perforation, and the probability of stenosis and postoperative delayed hemorrhage were 0% (0/58), 8.62% (5/58) and 3.45% (2/58). Conclusion ESD The detection rate of esophageal early cancer is significantly increased after operation. Preoperative biopsy is of guiding significance for diagnosis and treatment. ESD treatment can reduce missed diagnosis of early esophageal cancer.
【作者单位】：山东大学第二医院消化内科;
【分类号】：R735.1

【相似文献】